Cutting and Self-Harm: Warning Signs and Treatment
Parents should watch for symptoms and encourage kids to get help.
Turning Inward to Heal
Many kids haven't thought about it at all -- exactly why they self-injure,
says Lader. "It's like any addiction, if I can take a pill or self-medicate in
some way, why deal with the problem? We teach people that cutting only works in
the short term, and that it will only get worse and worse."
When kids learn to face their problems, they will quit self-harming, she
adds. "Our goal is to get them to communicate what's wrong. Babies don't have
the capacity for language, so they use behavior. These adolescents regress to
that preverbal state when they self-harm."
Individual and group therapy are the hubs of this treatment program. If
there is underlying depression or anxiety, antidepressants may be prescribed.
The patients also write regularly in their journals -- to learn to explore and
express their feelings.
Helping them gain self-respect and self-esteem is a critical treatment goal,
Conterio tells WebMD.
"Many kids have difficulty dealing with situations and people that make them
angry," Lader adds. "They don't have great role models for that. Saying no,
standing up to people -- they don't really believe they're allowed to do that,
especially girls. But if you can't do that, it's very difficult to maneuver the
world, survive in the world without someone stronger, more capable than you to
fight your battles."
Circular negative thinking keeps kids from developing self-esteem. "We help
them empower themselves, take risks in confrontation, change how they view
themselves," says Conterio. "If you can't set limits on someone else's
behavior, stand up to them -- you can't like yourself. Once these girls learn
to take care of themselves, stand up for what they want, they will like
"We want them to get to the point where they believe, 'I am somebody, I do
have a voice, I can make changes, instead of, 'I'm nobody,'" she says.
One study of the SAFE program showed that, two years after participating,
75% of patients had a decrease in symptoms of self-injury. An ongoing study is
indicating a decrease in hospitalizations and emergency room visits.
"I've been doing this for 20 years, and the success rate is far greater than
the failure rate," says Conterio. "We truly believe that if people can continue
to make healthy choices, they won't go back to self-harm. We get emails that
are a blast from the past. Some patients do extremely well. Others regress.
Others have finally decided to do the work they learned here. When they apply
it, they do well. It all goes back to choice."
The bottom line: "When kids decide they don't want to cut any more - and
they get stressed again -- they have to be able to manage stress as it arises,"
Rosen says. "They can't succumb to cutting. People who can figure out some
alternative way to manage stress will eventually quit it."